Individual provider · NPI-1

Winifred Mary Fusco, PTA

Physical Therapy Assistant · Jamaica, NY

NPI number1811266653
StatusActive
Last updated in NPPESDec 23, 2011

Details

NPI
1811266653
Entity type
Individual (NPI-1)
Name
Ms. Winifred Mary Fusco
Credential
PTA
Sex
Female
Sole proprietor
Yes
Enumeration date
Dec 23, 2011
Last updated
Dec 23, 2011

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
225200000X Physical Therapy Assistant006219-1NYYes

Practice location

9110 146th St
Jamaica, NY 11435-4301

Phone 718-523-7408

Mailing address

7104 Juniper Valley Rd
Middle Village, NY 11379-1839

Phone 917-974-4854

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